M21-1 Manual  /  Part XIII, Subpart i, Chapter 3, Section F

Medical Treatment for Veterans Treated with Nasopharyngeal Radium Irradiation (NRI)

M21-1, Part XIII, Subpart i, Chapter 3, Section F

Overview

In This Section

 This section contains the topic, "Eligibility Requirements for Veterans Treated With NRI."

1. Eligibility Requirements for Veterans Treated With NRI

Introduction

 This topic contains information on eligibility requirements for Veterans treated with NRI under 38 U.S.C. 1720E, including
  • description of NRI
  • background on NRI use in the military
  • policy on services provided to Veterans
  • eligibility requirements for medical care
  • types of examinations and care offered, and
  • regional office (RO) involvement in verifying eligibility.

Change Date

August 27, 2026

XIII.i.3.F.1.a. Description of NRI

Nasopharyngeal radium irradiation (NRI)is a technique developed in the 1920s that used radium to treat hearing loss caused by repeated ear infections. This technique was also used for treating other conditions including

  • sinusitis
  • tonsillitis
  • asthma
  • bronchitis, and
  • repeated viral and bacterial infections.

XIII.i.3.F.1.b. Background on NRI Use in the Military

Because NRI was effective in treating otitis media, military physicians used NRI to treat aerotitis media (barotrauma) in submariners, aviators, and divers due to enlarged tissue in the throat combined with rapid pressure changes.

XIII.i.3.F.1.c. Policy on Services Provided to Veterans

 The Department of Veterans Affairs (VA) is authorized to provide Veterans with a medical examination, hospital care, medical services, and treatment for any cancers of the head or neck found to be associated with the Veteran’s receipt of NRI treatment during active service. Reference: For more information on NRI, see 38 U.S.C. 1720E.

XIII.i.3.F.1.d. Eligibility Requirements for Medical Care

To be eligible for VA medical care under 38 U.S.C. 1720E, the Veteran must have

Notes:

XIII.i.3.F.1.e. Types of Examinations and Care Offered

 Veterans with head or neck complaints or who are concerned about the possible adverse effects of NRI treatments will be offered the opportunity to receive an Ionizing Radiation Registry examination. Examination by an ear, nose, and throat specialist and additional studies, such as biopsies, will be performed if clinically indicated. Provision of other services for Veterans receiving medical care due to NRI treatment is dependent on eligibility, as determined by the medical facility.

XIII.i.3.F.1.f. RO Involvement in Verifying Eligibility

 If a VA medical facility cannot verify eligibility for medical care under 38 U.S.C. 1720E based on the information of record, it may send a request for verification of eligibility to the regional office (RO). The RO must then

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Source: VA M21-1 Adjudication Procedures Manual, M21-1, Part XIII, Subpart i, Chapter 3, Section F (U.S. government work, reproduced for reference). Browse all sections →